Reasons for dental visits and needs for oral health/disease after 50 years in the arsenic poisoning patients caused by dried milk

应用pre - proceed （P-P）模型，阐明Hikari协会的健康促进活动与干奶引起的砷中毒患者50年后口腔健康之间的因果关系。523例患者回答了协会口腔健康及健康促进活动问卷（回收率60%）。方法：对本组患者口腔健康状况资料与1987年的资料进行比较。采用线性结构关系（LISREL）程序对P-P模型进行检验。结果：在1987年的调查中，超过80%的参与者报告说他们直到牙痛才去看牙医，而在2007年的调查中，有66%的人同意这一说法。这种不规律的出勤率从1987年的80%下降到2007年的66%。36%的参与者报告说他们在1987年认真刷牙，而47%的人同意这一说法。P-P模型最初并没有被发现与从研究参与者那里收集到的实际数据一致。“促成因素”对“环境”和/或“健康行为”没有显著影响。同样，“健康行为”和“环境”对健康（问题）都没有显著影响。LISREL诊断信息显示，“诱发因素”影响“健康”和生活质量，“环境”影响“强化因素”、“使能因素”影响“健康”。根据这些发现，对P-P模型进行了更改。改进后的模型整体拟合效果满意（GFI=0.973， AGFI=0.935， RMSEA=0.075）。结论：改进的P-P模型表明，加强健康行为和/或社区内的易感因素可以改善社区居民的生活质量。在本研究条件下，如果不考虑P-P模型中变量的重新定位，健康促进活动可能不符合患者行为改变的现实。少

To clarify causal relationships between health promotion activities in the Hikari association and the after-50-year oral health of the arsenic poisoning patients caused by dried milk using the PRECEDE-PROCEED (P-P) model. 523 patients answered the questionnaire regarding oral health and health promotion activities in the association (recovery rate 60%). Methods: The present data regarding oral health circumstances of the patients were compared with those of 1987. The P-P model was tested by a linear structural relations (LISREL) program. Results: More than 80% of the participants reported that they put off going to the dentist until they had toothache in the 1987 survey, whereas 66% agreed with this statement in the 2007 survey. The percent of this irregular attendance pattern decreased from 80% in 1987 to 66% in 2007. 36% of the participants reported that they brush each of their teeth carefully in the 1987, whereas 47% agreed with this statement. The P-P model was not found initially … More , to be consistent with the actual data collected from study participants. The “enabling factors " did not have significant effects on “environment" and/or “health behavior". Similarly, neither “health behavior" nor “environment" had significant effects on health (problem). LISREL diagnostic information revealed that the “predisposing factors" affected “health" and QOL, and that the “environment" affected the “reinforcing factors", “enabling factors" to affect “health". In the light of these findings, changes to the P-P model were made. The overall fit of the modified model was improved and judged to be satisfactory (GFI=0.973, AGFI=0.935, RMSEA=0.075). Conclusions: The modified P-P model showed that the QOL would be improved by strengthening health behavior and/or the predisposing factors within the community. Under the conditions of this study, health promotion activities might not fit the reality of patient's behavioral change without consideration to re-orienting the variables within the P-P model. Less